| NAME |
EVANSVILLE CBOC |
| STATE |
INDIANA |
| STREET ADDR. 1 |
6211 E WATERFORD BLVD |
| CITY |
EVANSVILLE |
| ZIP |
47715-2869 |
| OFFICIAL VA NAME |
EVANSVILLE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
EVANSVILLE VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1952356115
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
657GJ |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1952356115
-
- CODING SYSTEM: VASTANUM
- ID: 657GJ
-
- CODING SYSTEM: CLIA
- ID: 15D0987278
|
